High Cholesterol


High Cholesterol



Over-the-counter Drugs

What Leading Medical Organizations Recommend When Lowering Cholesterol to prevent heart attack and stroke


Recommendations about cholesterol lowering vary according to your chance of heart attack and stroke. To reduce your chances, the American Heart Association recommends that...

  • Everyone avoid cigarettes. Not smoking is the most powerful way to lower the chance of dying from many diseases, including heart or vascular disease, lung cancer and emphysema. Exercise, a prudent diet, controlling weight, blood pressure and diabetes is also suggested.
  • People at high risk should take a STATIN (such as simvastatin). You are considered to be at high risk if you have had a heart attack or stroke or mini-stroke (TIA), bypass surgery or stents, have chest pain with exertion (angina), peripheral vascular disease or diabetes.
  • People not at high risk - no prior heart disease or any of the other problems listed above - who are between 40 and 79 years old should calculate their heart attack and stroke risk (you can use the American Heart Association's 10-year heart attack or stroke risk at http://tinyurl.com/mjfnrn3).

If your risk is...

  • less than 5% risk, American Heart Association suggests no statin
  • 5% to 7.4% risk, they suggest you consider a statin
  • 7.5% or higher risk, they suggest you take a statin


Aspirin does not lower cholesterol but it can be used to reduce heart and stroke risk:

  • People at high risk  The American Heart Association (and all major medical organizations) recommends that people able to use aspirin take 75mg to 162mg daily
  • People not at high risk The American Heart Association recommends that people able to use aspirin take it if their 10-year heart attack or stroke risk is 6% or higher.  The FDA, however, disagrees  - it does not believe the evidence supports the general use of aspirin for primary prevention of a heart attack or stroke because of concerns about bleeding in the stomach and brain.


American College of Cardiology/American Heart Association Task Force on Practice Guidelines2013 ACC/AHA Guideline on the Assessment of Cardiovascular Risk. Published November 2013.
American Heart Association and American College of Cardiology Foundation. AHA/ACCF Secondary Prevention and Risk Reduction Therapy for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2011 Update. Published November 2011.
American Heart Association/American Stroke Association. Guidelines for the Primary Prevention of Stroke. Published February 2011.
FDA. Use of Aspirin for Primary Prevention of Heart Attack and Stroke. Published May 2014.